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Sciatica and Piriformis Can Be a Pain in the Butt

Sciatica and Piriformis Syndrome are both pathologies that involve the impingement of the sciatic nerve. This nerve comes from your lower back and follows through the buttocks, past the hip, down the leg and all the way through the toes. Sciatica pain is caused by pinching, compressions, inflammation or irritation of the sciatic nerve in the low back.

True sciatica

The most common cause of true sciatica is vertebral issues like a herniated or slipped disc causing excess pressure the nerve root. Seeing a Physical Therapist or Surgery may be required in this case.

Piriformis Syndrome

Piriformis Syndrome is also known as False Sciatica. This is due to sciatic nerve entrapment caused by muscles in the hip. While the glutes can play a role in this, the main culprit is often the Piriformis Muscle. 80-85% of sciatica is often due to the piriformis being tight. Leo Testut, a physician and anatomist, described that 25% of unlucky individuals actually have a sciatic nerve that goes through the piriformis muscle.

P-DTR Treatment for Piriformis Syndrome:

Since Piriformis Syndrome is due to issues of the piriformis this is the main targeted muscle. If the Piriformis is hypertonic this means it is neurologically tightened and will also stay that way to compensate for other patterns. With P-DTR we can assess this muscle and help it relax, thus relieving the pressure on the sciatic nerve. Often times individuals can get an MRI and it will not show issues with this muscles or entrapment at this site, this is often due to a positional problem. Perhaps the piriformis is not dysfunctional when laying face up during imaging but when taken into a standing or seated position it compensates creating the pain. P-DTR has the tools to assess and treat Piriformis Syndrome.

Massage Treatment for Piriformis Syndrome

Massage Therapy can be used to help relieve sciatica by working on the piriformis muscle. Massage therapy is meant to help inhibit muscles so this will help if the muscle is hypertonic. If the muscle is just tight with neurological issues manual therapy is a great way to loosen the muscle, boost blood flow to the area, stimulate the lymphatic system and releases natural opioids helping to decrease pain.

Piriformis Syndrome Self-care:

For people looking for relief of this muscle foam rolling and stretching are highly effective for inhibiting the piriformis.


One of the most important things with sciatica is to determine if it is due to a hardware issue with spinal issues or other nerve impingement caused by bones or damage to the nerve itself. Be sure to check in with your physician for the proper imaging. If this is due to issues with the muscle compressing the nerve then often proper care like functional neurology, massage, foam rolling, and stretching can be used to relieve this issue.

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